[Advances and prospects of hemostatic strategies in hepatic surgery]

T A Xie1, S Y Peng2, X T Hou1

  • 1Department of General Surgery,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine,Hangzhou 310016,China.

The liver is characterized by abundant blood supply and intricate anatomical architecture,rendering intraoperative and postoperative hemorrhage a primary clinical challenge. Conventional compression and suture ligation fail to enable precise perioperative hemorrhage prediction. Driven by the integration of precision medicine,artificial intelligence,and biomaterials,hemostatic strategies are undergoing a paradigm shift from passive compression to precise targeted intervention. This paper systematically reviews advances and future perspectives in hemostatic strategies for hepatic surgery. Preoperative individualized intervention is achieved via tranexamic acid prophylaxis,portal vein embolization,and radiological assessment; intraoperatively,Peng's curettage-suction technique enhances hemorrhage control; postoperatively,tiered "pharmacological-interventional-surgical" management allows proactive whole-course hemostatic regulation. Looking ahead,nano-drug delivery systems coupled with artificial intelligence closed-loop frameworks will facilitate the integrated development of hemostasis,liver regeneration promotion,and postoperative recurrence inhibition.

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